Provider Account Manager

About the role

The Provider Account Manager (PAM) is an Arizona market-based position responsible for Recruitment & Contracting; Account relationship management/retention; and Performance Management of providers/practices with less than 2000 members.

Responsibilities

• Growth Key Responsibilities:
  • Recruitment & Sales
  • Lead generation and recruitment and finalize contracting and enrollment process
  • Develop and present business value proposition to practices to include physicians, practice staff, and other key stakeholders as needed
  • Pipeline management to move provider practices/hospitals/clinics to execution
  • Prospect new providers for recruitment/growth
  • Conduct local market research to ensure strong understanding of market needs and identification of prospects
  • Secure provider signatures to enroll practices and ensure completion of all onboarding documentation
  • Manage payer addendum opportunities to drive membership density among Equality Health Network participating practices
  • Participate and actively engage in provider/community events
  • Achieves market growth goals
• Salesforce Maintenance
• Maintain CRM (Salesforce) account information and activities of assigned practice groups: practice profile, key practice contacts, document meeting events & communication, etc.
• Retention/Account Management
• Service Delivery & Recovery
• Serve as primary contact and relationship manager for ongoing communication with all assigned accounts, ensuring trust, engagement, and customer satisfaction
• Welcome and onboard new practice group(s) into the EQH network & model: EQH welcome presentation, practice transformation training, and support expectations
• Schedule, lead, and manage recurring business and clinical operational touchpoints
• Monitor provider usage of Care Empower and provide ongoing coaching of proper usage of Care Empower (Worklists, Chart Prep Tool, etc.)
• Facilitate support for initial and supplemental training with appropriate centralized teams for the following: CareEmpower (CE), ECIP incentive program
• Manage roster reconciliation, opt-ins and renewals
• Manage provider documentation requests from payer. Review, address and process terminations from practices as needed
• Triage, address, and resolve provider inquiries and concerns promptly to sustain positive partnerships

• Lead and manage overall program performance for providers with less than 2000 lives (Established Markets) and less than 1000 lives (Emerging Markets)
• CE Usage / Quality
• Facilitating CE usage and troubleshooting (e.g. worklist management and associated patient scheduling, leveraging Chart Prep Tool, etc.)
• Establish practice group’s weekly, monthly operational goals to achieve annual performance goals in Access to Care, Wellness, TOC and HRM (from Care Signals)
• Evaluate practice progress and performance against goals
• Identify practice barriers and support practice with recommendations to overcome barriers to performance
• ECIP
• Consult with practices to review ECIP performance, opportunities, and actions that fully optimize incentive opportunity
• Address issues, concerns, feedback from practices on ECIP program, including ECIP payment and data validation
• Monitor and Reporting
• Deliver practice performance reports: Quality, TOC, HRM
• Deliver practice ECIP payment dashboards and member detail reports
• Respond to requests for ad hoc reporting needs to support the practice

Qualifications

• Bachelor’s degree in Business, Healthcare Administration or a related field of study; or an equivalent combination of education and/or experience
• Minimum four (4) years of experience in healthcare; network development, account management or other related positions
• Experience working with providers through an ownership model, partner arrangement or other affiliation
• Travel by personal automobile to multiple community locations. Up to 25% local travel throughout Arizona
• Communication (verbal and written): Demonstrated ability to communicate with customers in a clear, persuasive, and professional manner; experienced in delivering customer facing presentations that resonates with the customer while demonstrates company’s value add. Able to convey complex or technical information in a manner that others can understand
• Relationship Management: Client focused and empathetic, ability to influence key stakeholders, facilitate conflict resolution
• Problem Solving: Ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action. Collaborative: Highly collaborative individual with the ability to work effectively across a matrixed organization to deliver on customer expectations and resolve issues
• Proficiency with MS Office applications and web-based technologies

Preferred Skills & Qualifications

• Demonstrated understanding of risk and value-based contracting
• Experience with sales initiatives, provider research and market analysis
• Familiar with conventional payment methodologies (CMS-RBRVS)
• Familiar with payment alternatives such as fee for service, capitation, global budget, performance compensation and episode of care payment
• Familiar with patient and practice risk adjustment mechanics and premium-based payment methodologies
• Familiar with patient and practice risk adjustment mechanics, APR; HCC/RAF
• Experience with CRM platforms/tools